Grand Rounds
Observations on real estate, tax architecture, and the structural decisions that matter for healthcare households. Written by John Lee.
July 2026
A mid-year reminder for high-W-2 clinicians on the real estate tax levers — depreciation, cost segregation, and the short-term rental strategy — as education, not advice.
Read →June 2026
Mid-year is a natural window for high-earning clinicians to act on a first rental. A note on physician loans, mortgage rates, and the house-hack.
Read →May 14, 2026
No Fed cut. No headline event. Just a quiet 45-basis-point drift that may have moved the deal you walked away from last fall back into DSCR territory.
Read →May 5, 2026
NAR's Q1 metro report shows a country split four ways. A note on building a real market thesis instead of buying the national narrative.
Read →April 21, 2026
NAR's March pending home sales surprised to the upside. The signal underneath the number is the part operators should be reading.
Read →April 6, 2026
The IRS released guidance for governors to nominate new Qualified Opportunity Zone tracts. What changed, who should care, and who shouldn't.
Read →March 18, 2026
Three consecutive Fed holds. The wishful-thinking version of underwriting needs to be retired. Here's what operators are doing instead.
Read →March 5, 2026
A meaningful share of the IRS's annual scam list is pitched, year after year, to high-earning professionals. Three patterns to recognize.
Read →February 20, 2026
IR-2026-25 sounds like it's about factories. The IRS definition is broader than it looks — and catches a quiet category of healthcare-adjacent real estate.
Read →February 4, 2026
The Fed quietly signaled stable lending appetite for regional banks. For healthcare investors shopping small commercial real estate, that matters more than the 30-year rate.
Read →January 14, 2026
The IRS confirmed today what real estate operators have been waiting for. The structural math just changed for high-W-2 healthcare households.
Read →January 9, 2026
The IRS opened the OBBB instruction book. Worth slowing down on this one — the structural opportunity for high-W-2 healthcare households is meaningful.
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